Urinary Neutrophil Gelatinase-Associated Lipocalin Values in Preterm Neonates: A Systematic Review and Meta-analysis

Tahagod Mohamed; Robin Alexander; Brielle Davidson; Brett Klamer; Alison Gehred; Michelle C. Starr; Cara Slagle; Catherine Krawczeski; Matthew W. Harer

doi:10.1055/a-2417-4087

American Journal of Perinatology, Table of Contents

Am J Perinatol 2025; 42(05): 683-688
DOI: 10.1055/a-2417-4087

Original Article

Urinary Neutrophil Gelatinase-Associated Lipocalin Values in Preterm Neonates: A Systematic Review and Meta-analysis

Authors

Tahagod Mohamed

¹Division of Nephrology and Hypertension, Department of Pediatric, Nationwide Children's Hospital, Columbus, Ohio

²The Kidney and Urinary Tract Center, Department of Pediatric, Nationwide Children's Hospital, Columbus, Ohio
Robin Alexander

³Center for Biostatistics, The Ohio State University, Columbus, Ohio
Brielle Davidson

⁴The Ohio State University College of Medicine, Columbus, Ohio
Brett Klamer

²The Kidney and Urinary Tract Center, Department of Pediatric, Nationwide Children's Hospital, Columbus, Ohio
Alison Gehred

⁵Nationwide Children's Hospital, Columbus, Ohio
Michelle C. Starr

⁶Division of Pediatric Nephrology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
Cara Slagle

⁷Division of Neonatal-Perinatal Medicine, Riley Children's Hospital, Indiana University, Indianapolis, Indiana
Catherine Krawczeski

⁸Division of Pediatric Cardiology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
Matthew W. Harer

⁹Division of Neonatology, Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin

Abstract

Objective

Acute kidney injury (AKI) is common in hospitalized preterm neonates. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a promising noninvasive AKI biomarker. However, normal values of uNGAL in preterm neonates without AKI are poorly characterized. The objective of this study was to evaluate the current literature to determine normal uNGAL values for preterm neonates without AKI.

Study Design

Systematic review and meta-analysis of all articles published before November 2021 evaluating uNGAL values in preterm neonates without AKI.

Results

Of 1,607 studies evaluated for eligibility, 11 were included in the final meta-analysis (210 males, 202 females). uNGAL values were higher in the preterm neonates <29 weeks and ranged between 20.7 and 782.65 ng/mL. Meta mean estimates of gestational age (GA), birthweight, and neutrophil gelatinase-associated lipocalin were 29.4 weeks (95% confidence interval [CI]: 28.8–30.0), 1,241 g (95% CI: 1,111–1,372), and 148.9 ng/mL (95% CI: 48–231), respectively.

Conclusion

In limited studies, a wide range of uNGAL values in preterm neonates without AKI are reported. Future studies should identify normal uNGAL values in preterm neonates using larger cohorts by GA and birthweight.

Key Points

Urinary NGAL is a promising noninvasive biomarker of neonatal AKI.
A wide range of uNGAL is reported in preterm neonates but the baseline values are not well defined.
Urine NGAL values are higher in extremely preterm compared with preterm neonates.

Keywords

NGAL - neonatal AKI - acute kidney injury - urine NGAL - urinary NGAL

Full Text

References

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